Bloat -- How Diagnose?

[Guest trevdog]

How is he this morning? This is similar to what I am dealing with in Dallas, although she doesn't gulp her food. Vet said to give Gas-x at the onset, if that doesn't seem to be helping, get her in for xrays. So far both times it hasn't helped, just time and some Reglan. We have also changed her food and put her on probiotics. Not that it's helping but it's been almost 3 months since the last flare up. Last time it wa so bad the bacteria from whatever is causing the buildup caused a liver infection.

[greyhead]

If he has a history of SIBO and Clostridium infection, I would retest for that. They might have come back. Have you tried adding a probiotic supplement? I would also deworm him to be safe (Panacur to get Giardia too).

He never does well on probiotics, which is really weird I know. But maybe I should try them again on the theory that the setback he has shown when he gets them was just coincidental to taking them and really was due to something else?

The SIBO was probably triggered by the initial antibiotics he was on, but impaired intestinal motility can cause another flare-up.

Yes, I think that was the trigger too. Which is why I wish I hadn't spent so much time believing that soft yellowish poop is not entirely abnormal for a greyhound! And it makes sense that he could have another SIBO flare-up, but it hadn't occurred to me. I'm not used to thinking about motility at all. Thanks for the suggestion!

 

If you don't mind, I'd like to email some of your post to my vet so I can get Reglan. She's out of the office for a week, but I have her home email. I doubt the other vets in her office will want to contradict her diagnosis, nor do I want to embarrass her that way when I don't need to.

 

ETA: Forgot to mention that he has systematized hookworm -- long story -- and has been getting Drontal-Plus once a month for several months. Shall I add that he's hypothyroid too? This is a very tough, smart, noble animal, and I admire and love him beyond measure. It has been a fight to get vets and others from the beginning four years ago to take his symptoms seriously and respond promptly. Good thing I'm a fighter too and an even better thing that GT offers so much to us!

Edited July 9, 2009 by greyhead

[greyhead]

How is he this morning? This is similar to what I am dealing with in Dallas, although she doesn't gulp her food. Vet said to give Gas-x at the onset, if that doesn't seem to be helping, get her in for xrays. So far both times it hasn't helped, just time and some Reglan. We have also changed her food and put her on probiotics. Not that it's helping but it's been almost 3 months since the last flare up. Last time it wa so bad the bacteria from whatever is causing the buildup caused a liver infection.

He's much better, thanks, from what I can tell so far. I'm bringing his food to room temp now, which takes about an hour. Then maybe I'll feed it to him in segments to slow him down! He asked for his late-night snack last night but didn't get it -- my attempt to rest his gut a bit. But I hate doing that, partly because he lost so much muscle and partly because I tend to trust his ability to know what he needs!

 

Liver infection! What were the symptoms and how did you find out? Did she have really light yellow/white poop ever? And what food change did you make? I'm so glad she's doing better! (I'm going to try probiotics again too, but it sounds like Reglan is the crucial piece of this puzzle at the moment.)

[Batmom]

Careful with Reglan. Don't think you want to use it if you suspect intestinal slow-down/overfullness. IIRC it acts to mobilize the stomach, not the intestines, so if you have slow guts you don't want to compound that. Your vet will be able to advise .

[greyhead]

Careful with Reglan. Don't think you want to use it if you suspect intestinal slow-down/overfullness. IIRC it acts to mobilize the stomach, not the intestines, so if you have slow guts you don't want to compound that. Your vet will be able to advise .

Well, shoot, it was so much simpler before! But I see your point and I'm glad you made it.

[Guest kydie]

I know your discuss, I have a GSP with IBD and this gassy, hyperactivity of the gastric area is part of it, I can't tell you the expense this put us through years ago, then followed my instinct, saw a holistic vet, and have not had issues in many years, I hope your pup is o.k.

[Burpdog]

soft yellowish poop

 

If it's the color of baby crap, get a test for pancreatic insuffiency done and also a gluten intolerance.

 

You can try home cooking and see if you have good results: meat with potatoes for a few days and see how he reacts.

 

What are you feeding?

[Guest LindsaySF]

Careful with Reglan. Don't think you want to use it if you suspect intestinal slow-down/overfullness. IIRC it acts to mobilize the stomach, not the intestines, so if you have slow guts you don't want to compound that. Your vet will be able to advise .

Reglan (Metoclopramide) also works on the intestines. Mostly the upper small intestine. It is sometimes prescribed for animals with intestinal motility problems following surgery, etc. It is also the drug of choice for rabbits with gastrointestinal stasis (my rabbit Jackie went through a bout of this). I don't think Reglan has any effect on the large intestine though.

 

 

soft yellowish poop

If it's the color of baby crap, get a test for pancreatic insuffiency done and also a gluten intolerance.

Agreed. Coincidentally, SIBO can be secondary to EPI (Exocrine Pancreatic Insufficiency).

 

 

 

From this site on SIBO:

 

Secondary SIBO: This is a sequela to a number of primary conditions including chronic Giardia, EPI, motility disorders, intestinal obstruction, or dietary sensitivity. Clinical signs usually pertain to the primary condition.

 

 

Not sure if chronic hookworm can play a part in SIBO, I'll have to look into that. I would continue with the monthly deworming, that sounds good. Drontal Plus would get Giardia too, if the Flagyl didn't take care of it first. (Edit: What is the deworming schedule each month? How many days of the Drontal Plus does he get? Usually it is 3 consecutive days but in chronic cases you can give a longer course, something like 5-7 days, to try to knock the buggers out).

 

 

 

 

 

~Lindsay~

 

 

Edited July 9, 2009 by LindsaySF

[Guest LindsaySF]

Just found this article. It mentions another gastrointestinal motility drug, Cisapride, which is better at affecting the motility of the large intestine (colon). Maybe a combo of Reglan and Cisapride would help his intestinal motility problems.

 

 

 

~Lindsay~

 

 

[Guest trevdog]

Dallas has always had good poops even during her episodes. She may also have SIBO as suggested. But her symtoms are very similar to your pups, she gets very lethargic, tight tummy or slightly swollen and can't settle down or get comfortable. Back in her puppy days she did have to have emergency surgery for an obstruction, so we always have that worry when she has done this. I watch her like a hawk and she doesn't get anything other than bully stix to chew, but you never know with her. Xrays show a buildup of gas and some dark spots in her intestines which they can never tell what it is, and her tummy and intestines get all jumbled up - looks really wierd on the xrays too. The vet always ends up giving barium which so far has gone through her thankfully and also helps to push the gas out. They always do blood work, the first time her kidneys were in acute failure, the last time the tests showed liver damage-can't remember the exact levels. It appears that the gases and food backup caused her organs to hold bacteria and caused her liver values to be way out of whack as it couldn't process everything. So she was on Denamarin for a month and retested. I know what you are going through, it's scary to see your pup feeling so bad and thinking it's bloat or an obstruction.

So to help, I switched her food to Taste of the Wild and added some probiotics although the vet doesn't feel a food change was needed, said it wouldn't hurt. So far so good...oh and she's a picky eater too.

 

She's been diagnosed with ileus, or so the vet calls it, but basically, it's IBD.

[greyhead]

If it's the color of baby crap, get a test for pancreatic insuffiency done and also a gluten intolerance.

 

You can try home cooking and see if you have good results: meat with potatoes for a few days and see how he reacts.

 

What are you feeding?

 

Color is good now. When color was baby-crap or even white at times, tested for EPI was negative. Vet's theory was that bile duct was swelling almost shut intermittently; it's apparently really small to begin with. Color improved with SIBO antibiotics. Haven't tested for gluten intolerance; nobody suggested it before but it sounds like a good idea!

 

He got steamed chicken for months but diarrhea returned badly. Same with beef and buffalo. This was all before resumption of Flagyl and starting budesonide for IBD. Since then he has tolerated venison really well. He refuses carbs entirely but gets a little sweet potato without his knowledge in his Natural Balance venison/s.p. formula. He gets 1.5 cups a day of that and about 1.5 lbs of raw venison, from which I pick out all the fat I can. Tried a really small amount of probiotics (FortiFlora) again this a.m. and he just rejected the food. Ate it fine later w/o the FF. I've experimented, and unless he gets this exact combo of kibble and raw, he reverts to D.

 

Don't suppose you make any biskies for a guy like this?!

[greyhead]

Thanks for the tip on Cisapride and the citations!

 

(Edit: What is the deworming schedule each month? How many days of the Drontal Plus does he get? Usually it is 3 consecutive days but in chronic cases you can give a longer course, something like 5-7 days, to try to knock the buggers out).

~Lindsay~

He gets one day of Drontol Plus per month. This followed a year and a half of monthly treatment with Advantage Multi, which followed all the usual standard rounds of Panacur (repeatedly) and then Droncit + Strongid (there had been tapeworms in our other grey) every 3 months for a year, after which Spencer again tested positive for hooks. But it had taken 9 months and three vets to diagnose him initially, by which time they were in his lungs, in the soil, and probably elsewhere in his body. So we don't expect to ever be entirely rid of them. But I haven't seen any indication that they are a factor lately. Internist just suggested the Drontal to be sure!

 

He did have stomach issues from the very beginning. After the first negative fecal they said it was probably from treats. After the second negative fecal at the second vet, I was told it was probably emotional problems. The third vet found them because we got lucky & tested at the right time; by then he said he was astonishingly loaded with hooks. Meanwhile we had changed his food multiple times, thinking it might be that, which is why finding novel proteins now for his IBD is a challenge. Point being really, I'm sure his hookworms affected his intestines negatively! But I think the antibiotics after the last dental encouraged the Clostridium SIBO, which also went undiagnosed for months and maybe set him up for the IBD. But I doubt we'll ever know for sure exactly what led to what.

[greyhead]

... Xrays show a buildup of gas and some dark spots in her intestines which they can never tell what it is, and her tummy and intestines get all jumbled up - looks really wierd on the xrays too. ...She's been diagnosed with ileus, or so the vet calls it, but basically, it's IBD.

Wow, that sounds like a really complicated and challenging set of problems. For some reason, just off the wall, I'm thinking of adhesions, where tissue sticks to other tissue. I imagine that could make things jumble and look weird on x-rays. I know it can happen in women's reproductive systems, and I think it can happen in the digestive system too. Has that been discussed? I don't know what ileus is, but I'll look it up just to see.

 

Thanks for writing. Though I hate what you and Dallas have been going through, I like having your company in this mess. She said selfishly! (I'd put an icon here but they're not working right now. Imagine the one with the woman ripping her hair out!)

[Batmom]

Thanks, Lindsay, for the accurate meds info!

 

Mary, best luck with your darling boy.